2016
Version 1, Mar 2016; Update due May 2016
Pete Driscoll: Programme Lead
Jane Rutt-Howard: Senior Lecturer
1st University Placement
Physician Associates Programme
School of Medicine & Dentistry
Course Specifications
2
Table of Contents
TABLE OF CONTENTS ........................................................................................................................................ 2
WEEKLY TIME TABLE ........................................................................................................................................ 4
WEEK 1, FEBRUARY 1ST
2016.................................................................................................................................... 4
WEEK 2, FEBRUARY 8TH
2016 ................................................................................................................................... 4
WEEK 3, 15TH
FEBRUARY 2016 ................................................................................................................................. 5
WEEK 4, 22ND
FEBRUARY 2016 ................................................................................................................................. 5
WEEK 5, 29TH
FEBRUARY 2016 ................................................................................................................................. 6
WEEK 6, 7TH
MARCH 2016....................................................................................................................................... 6
WEEK 7, 14TH
MARCH 2016..................................................................................................................................... 7
EASTER HOLIDAYS ................................................................................................................................................... 7
WEEK 8, 4TH
APRIL 2016 ......................................................................................................................................... 7
WEEK 9, 11TH
APRIL 2016 ....................................................................................................................................... 8
WEEK 10, 18TH
APRIL 2016 ..................................................................................................................................... 9
WEEK 11, 25TH
APRIL 2016 ................................................................................................................................... 10
WEEK 12, 2ND
MAY 2016 ...................................................................................................................................... 11
WEEK 13, 9TH
MAY 2016 ...................................................................................................................................... 12
WEEK 14, 16TH
MAY 2016: EXAM WEEK .................................................................................................................. 12
WEEK 15, 23RD
MAY 2016 .................................................................................................................................... 13
WEEK 16, 30TH
MAY 2016 .................................................................................................................................... 13
COMMUNICATION ......................................................................................................................................... 14
THERAPEUTICS & PRESCRIBING ..................................................................................................................... 15
SYSTEM EXAMINATION.................................................................................................................................. 16
SINGLE SYSTEM EXAMINATIONS: ............................................................................................................................... 16
COMBINED SYSTEM EXAMINATIONS: ......................................................................................................................... 16
INVESTIGATION INTERPRETATION ................................................................................................................. 17
IMAGING ............................................................................................................................................................. 17
Types ............................................................................................................................................................ 17
Topics ........................................................................................................................................................... 17
ECG ................................................................................................................................................................... 17
Types ............................................................................................................................................................ 17
Topics ........................................................................................................................................................... 17
FULL BLOOD COUNT (FBC) & COAGULATION RESULTS .................................................................................................. 17
UREA AND ELECTROLYTE AND GLUCOSE RESULTS .......................................................................................................... 17
ARTERIAL BLOOD GAS (ABG) RESULTS ...................................................................................................................... 18
LIVER FUNCTION TESTS ........................................................................................................................................... 18
PROCEDURAL SKILLS ...................................................................................................................................... 19
REGULAR USE: ...................................................................................................................................................... 19
ANTT............................................................................................................................................................. 19
Injections: ..................................................................................................................................................... 19
Vital sign recording: ..................................................................................................................................... 19
Ophthalmoscopy .......................................................................................................................................... 19
Auroscopy .................................................................................................................................................... 19
Lifting & handling ......................................................................................................................................... 19
INTERMEDIATE LIFE SUPPORT SKILLS .......................................................................................................................... 19
3
OBSERVED & PRACTICED ON MODEL ......................................................................................................................... 19
WEEKLY CLINICAL CONDITIONS ...................................................................................................................... 20
RATIONALE FOR A CASE BASED COURSE ...................................................................................................................... 20
CASE BASED FOCUS ................................................................................................................................................ 20
SELECTION OF CASES .............................................................................................................................................. 20
CASES: ................................................................................................................................................................ 20
Community acquired pneumonia ................................................................................................................. 20
Asthma ......................................................................................................................................................... 21
COPD ............................................................................................................................................................ 21
Acute coronary syndrome ............................................................................................................................ 21
Left ventricular failure .................................................................................................................................. 21
Bleeding peptic ulcer .................................................................................................................................... 21
Variceal bleed .............................................................................................................................................. 21
Diverticular disease ...................................................................................................................................... 21
Ulcerative colitis ........................................................................................................................................... 21
Diabetes ....................................................................................................................................................... 21
Jaundice ....................................................................................................................................................... 21
Palpitations .................................................................................................................................................. 21
Fractured neck of femur ............................................................................................................................... 21
Hot joint (Infective) ...................................................................................................................................... 21
DVT (Leading to PE)...................................................................................................................................... 21
Hot joint (Arthritis) ....................................................................................................................................... 22
Cellulitis ........................................................................................................................................................ 22
Ischaemic Stroke .......................................................................................................................................... 22
Epilepsy ........................................................................................................................................................ 22
Syncope ........................................................................................................................................................ 22
4
Weekly Time table1
Week 1, February 1st 2016 AM PM
Monday Induction Induction
Tuesday ICS Anatomy - Intro
ICS Physiology – Intro & skin
Wednesday MS&PC Handwashing ANTT Vital Signs
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday MS&PC Introduction to therapeutic communication ICS Microbiology - Introduction Immunology - Introduction
MS&PC Clinical Case 1 – present (breathless & cough)
Friday MT&P (10-12) ‘One dose does not fit all’ Using the BNF / information sources Antibiotics
All Consolidate week with self-directed study Opportunity for academic supervision
Week 2, February 8th 2016 AM PM
Monday ICS Pathophysiology - Respiratory
ICS Physiology - Respiratory
Tuesday ICS Respiratory Anatomy
ICS Introduction to CXR interpretation Medical CXR conditions
Wednesday MS&PC Respiratory physical examination Peak flow MDI
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday MS&PC Calgary Cambridge & History taking ICS Microbiology – General principles of infection & how these pertain to Community Acquired Pneumonia Immunology
MS&PC Clinical case 1 – feedback Clinical case 3 – present (wheeze & cough)
Friday MT&P Resp: drugs for the lungs / asthma drugs and peripheral nervous system
All Consolidate week with self-directed study
1 ICS = integrated clinical sciences, MS&PC = medical skills & patient care, MT&P = medical
therapeutics & prescribing
5
Week 3, 15th February 2016 AM PM
Monday ICS Pathophysiology - Cardiovascular
ICS Physiology - Cardiovascular
Tuesday ICS Anatomy – Mediastinum
ICS System for interpreting Medical CXR Trauma CXR and interpretation Applied anatomy of chest drain
Wednesday MS&PC Cardiac physical examination Taking an ECG
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday ICS Microbiology – General principles of infection & how these pertain to COPD Haematology – Blood cells – types, formation and function
MS&PC Clinical case 3 – feedback Clinical case 5 – present (COPD)
Friday MS&PC Complete generic hx & resp hx MT&P COPD meds Analgesia 1: opiates
All Consolidate week with self-directed study
Week 4, 22nd February 2016 AM PM
Monday ICS Pathophysiology - vascular
ICS Physiology - vascular
Tuesday ICS Vascular Anatomy – coronary; aortic arch and carotids Applied anatomy of thoracic emergency procedures
ICS ECG Introduction Rhythm strip interpretation ECG recording - Introduction
Wednesday MS&PC Chest exam (CVS & Respir) CXR interpretation
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday MS&PC Cardiac history taking ICS Microbiology - General principles of infection & how these pertain to endocarditis Immunology
MS&PC Clinical case 5 – feedback Clinical case 7 – present (chest pain)
Friday MT&P CVS 1: categories of meds (ACS, MI) Anti-arrhythmics
All Consolidate week with self-directed study
6
Week 5, 29th February 2016 AM PM
Monday ICS Pathophysiology - Renal
ICS Physiology - Renal
Tuesday ICS Anatomy: Thoraco-Lumbar spine: bones – structure & function
ICS ECG recording – Rhythm strip interpretation
Wednesday MS&PC Back examination Chest examination (Respir & CVS) ECG interpretation (rhythm strips)
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday MS&PC Calgary Cambridge, resp & cardiac Hx ICS Microbiology - Immunology
MS&PC Clinical case 7 – feedback Clinical case 9 – present (dyspnoea)
Friday MT&P CVS 2: hypertension heart failure
All Consolidate week with self-directed study
Week 6, 7th March 2016 AM PM
Monday ICS Pathophysiology – GI Tract
ICS Physiology – GI Tract
Tuesday ICS Anatomy: Organisation of the peritoneal cavity & Gastro-intestinal tract
ICS ECG – Introduction to 12 ECG interpretation Applied anatomical aspects of the gastro-intestinal tract
Wednesday All Student feedback (12-1pm) Opportunity for academic supervision Directed / self-directed study
MS&PC Abdominal physical examination ECG interpretation (12 lead & axis)
Thursday MS&PC Abdominal Hx and review SH & FH ICS Microbiology Immunology
MS&PC Clinical case 9 – feedback Clinical case 11 – present (Haematemesis & melaena)
Friday MT&P GI: motility, diarrhoea, anti-emetics, antacids
All Consolidate week with self-directed study
7
Week 7, 14th March 2016 AM PM
Monday ICS Pathophysiology – Renal; Pelvic &urinary
ICS Physiology – Renal; pelvic & urinary
Tuesday ICS Anatomy: Pelvis & urinary
ICS Applying Anatomy and physiology to common respiratory conditions
Wednesday MS&PC Torso exam + CXR & ECG (Respir; CVS & Abdo)
All Student feedback Opportunity for academic supervision Directed / self-directed study
Thursday MS&PC Review Pain assessment ICS Microbiology Immunology
MS&PC Clinical case 11 – feedback Clinical case 13 – present (lower abdominal pain)
Friday MT&P Diuretics, incontinence drugs
All Consolidate week with self-directed study
Easter Holidays
Week 8, 4th April 2016 AM PM
Monday 4th Opportunity for academic supervision Directed / self-directed study
Tuesday 5th ICS
Anatomy: Autonomic nervous system (AG)
ICS Physiology – Renal - U&E results (SJ)
Wednesday 6th MS&PC
Inguinal area & PR examination
Urine analysis
ABG interpretation
Student feedback MS&PC Pathophysiology: Respiratory 2 (PAD)
Thursday 7th MS&PC
9-11 Comms: Learning to listen
Endocrine History Taking
ICS
11-12 Microbiology –Fungal infection
12- 1 Immunology – Anaemia & introduce
transfusion
MS&PC
Clinical case 11 – feedback
Clinical case 13 – present
(lower abdominal pain)
Friday 8th MT&P
9-10 Mechanisms of prescribing, supplying
and administering medicines
10-12 Diabetes
ICS CVS pathophysiology 1 (JRH)
8
Week 9, 11th April 2016 AM PM
Monday 11th Opportunity for academic supervision Directed / self-directed study
Tuesday 12th ICS
Anatomy: GI review
Anatomy: Cervical spine
ICS
Physiology (SJ): Metabolism &
Nutrition 1; Exercise & BMI
Wednesday 13th
MS&PC
Cervical spine examination
Data interpretation: ABG/ CXR &
ECG
Abdo exam (complete)
Student feedback MS&PC
Applied anatomy of the cervical
spine & imaging
Thursday 14th MS&PC
9-11 Comms: Giving information.
Therapeutic communication during
physical exam
ICS
11-12 Microbiology – viral infection
12-1 Immunology - Clotting
MS&PC
Clinical case 13 – feedback
Clinical case 15 – present
(Diabetes)
Friday 15th MT&P
9-10 Pharmacovigilance, safe
prescribing & prescribing errors
10-12 Analgesia 2 - Anti-
inflammatory, local anaesthetics
ICS
Pathophysiology (SJ): Diabetes
and metabolic disorders
9
Week 10, 18th April 2016 AM PM
Monday 18th Opportunity for academic supervision Directed / self-directed study
Tuesday 19th ICS
Anatomy: Upper limb
ICS
Physiology (SJ): Metabolism 2;
GI tract; biliary & pancreas
Wednesday 20th
MS&PC
Hypertension – simulated cases
CSpine interpretation
ECG interpretation
Student feedback MS&PC
CVS pathophysiology 2 (JRH)
Thursday 21st MS&PC
9-1 Comms: Clinical decisions,
Red flags Hx taking DM & thyroid
MS&PC
Clinical case 15 – feedback
Clinical case 17 – present
(Jaundice)
Friday 22nd MT&P
9-10 Prescription writing (FP10,
drug chart acute care)
10-12 Thyroid, adrenal and steroids
ICS
Pathophysiology (SJ): Jaundice
10
Week 11, 25th April 2016 AM PM
Monday 25th
Opportunity for academic supervision Directed / self-directed study
Visit & presentation by PA (Ms Williams)
Tuesday 26th ICS
Anatomy: Revision (Min ARC)
(Christina)
ICS
Physiology (SJ): Metabolism 3,
Thyroid, adrenals & pituitary
Wednesday 27th MS&PC
Nutrition
Phlebotomy
Abdo x-ray interpretation
Student feedback MS&PC
Applying anatomy and
physiology knowledge to
interpret liver function tests
(PAD)
Thursday 28th MS&PC
9-1 Comms: Negotiation, +/-
vignettes
MSK History Taking
MS&PC
Clinical case 17 – feedback
Clinical case 19 – present
(Thyroid)
Friday 29th MT&P
9-10 Prescription writing for fluid
regimes
10-12 IV fluids
ICS
Pathophysiology (SJ): Endocrine
disorders
11
Week 12, 2nd May 2016 AM PM
Monday 2nd Bank Holiday
Opportunity for academic supervision Directed / self-directed study
Tuesday 3rd ICS
Anatomy: Lower limb
ICS
Physiology (SJ): Musculo-
skeletal
Wednesday 4th MS&PC
Shoulder examination
Neck examination
Student feedback MS&PC
Upper limb applied anatomy
Thursday 5th MS&PC
9-12 Comms: Breaking difficult
news/LTC.
ICS
12-1 Microbiology – infected
arthritis
MS&PC
Clinical case 19 – feedback
Clinical case 21 – present
(Fractured NOF)
Friday 6th MT&P
9-10 Legal framework. ADRs &
Yellow Card Reporting
10-12 Clotting: Warfarin & heparin;
anti-platelets, cholesterol
ICS
Pathophysiology (SJ): Muscle
and bone (including fractures)
Splints
12
Week 13, 9th May 2016 AM PM
Monday 9th Opportunity for academic supervision Directed / self-directed study
Tuesday 10th ICS
Anatomy: Neck triangles (AG)
ICS
Physiology (SJ): PNS
Wednesday 11th MS&PC
Knee examination
Lower limb PNS examination
Student feedback MS&PC
Applied anatomy of the lower
limb (PAD)
Thursday 12th MS&PC
9-11 Comms: Closing the
consultation. Safety netting. SBAR.
ICS
11-12 Microbiology – Catch up
12-1 Immunology – Catch up
MS&PC
Clinical case 21 – feedback
Friday 13th MT&P
9-10 Patient adherence, compliance
and concordance
10-12 Catch up
ICS
Pathophysiology (SJ): Impaired
mobility
Week 14, 16th May 2016: Exam week AM PM
Monday 16th Opportunity for academic supervision Directed / self-directed study
Tuesday 17th ICS
Anatomy: Revision
ICS
Physiology (SJ): Revision
Wednesday 18th UM4100 – 4300 Exam
2 hour MCQ exam
MS&PC
Ultrasound demonstration (Ms.
Birchill)
Thursday 19th UM4200
OSCE
UM4200
OSCE
Friday 20th MT&P
09:30-10: GB – PA in GP
10:00 – 11:00: Pharmacovigliance,
safe prescribing & prescribing errors
(JRH)
11:00 – 13:00: Antibiotics (JH)
ICS
Pathophysiology (SJ): Types of
shock and injury response
13
Week 15, 23rd May 2016 AM PM
Monday 23rd Opportunity for academic supervision Directed / self-directed study
Tuesday 24th ICS
Anatomy: CNS (AG)
ICS
Physiology (SJ): CNS & ICP
Wednesday 25th
MS&PC
Neuro examination – PNS & CNS
Student feedback MS&PC
Differentiating between PNS
and CNS lesions
Neuro imaging
Thursday 26th MS&PC
9-12 Comms: Neurological history
taking
ICS
12-1 Microbiology – Meningitis
MS&PC
Clinical case 25 – present
(Stroke)
Friday 27th MT&P
9-10 Prescribing for specific patient
groups (JRH)
10-12 Epilepsy medications (JH)
ICS
Pathophysiology (SJ): Stroke,
reduced consciousness;
syncope; seizure and raised ICP
Week 16, 30th May 2016 AM PM
Monday 30th Opportunity for academic supervision Directed / self-directed study
Tuesday 31th ICS
Anatomy: Special senses
ICS
Physiology (SJ): Special senses
Wednesday 1st MS&PC
Neuro examination (Cranial nerves)
Ophthalmology
Student feedback: MS&PC
Neuro catch up
Auroscopic examination
Thursday 2nd MS&PC
9-1 Comms: Prep clinical placement,
hx taking & SBAR
MS&PC
Clinical case 25 – feedback
Friday 3rd MT&P
9-10 Medication reviews &
Prescription writing (JRH)
10-12 Neuro-degenerative –
Parkinson’s (JH)
ICS
Pathophysiology (SJ): Sight,
hearing & balance
14
Communication This is taught as a whole group with occasions for smaller group sessions depending on the nature of
the session material.
During the first half of the block there is a strong focus on consultation skills, introducing the Calgary
Cambridge consultation model, core principles of communication and exploring history taking. They
are taught using the POMR approach and run in tandem with the clinical cases to consider focused
systems approach e.g. illustrating history taking from a respiratory perspective when the clinical case
is COPD and the anatomy, physiology and pathophysiology are all addressing the same system.
There is also the opportunity to recapitulate some key systems making effective use of clinical
scenarios and role play.
During the second half of the block (i.e. Post Easter break), there is a resumption of some of the
nuances of effective therapeutic communication where issues such a negotiation, communicating
with peers and breaking bad news are dealt with. We will be able to utilize service users from our
team at Commensus so that the students will have some real life experiences of talking with
patients. This enables the students to employ their skills in a safe and supportive environment whilst
being able to gain confidence. The service users are trained to role play (as needed) and to also
facilitate feedback from a patient perspective.
Competence will be assessed during the clinical OSCEs.
Session number
Date Time Broad session outline
1 04/02/16 9-11am Introduction to communication skills.
2 11/02/16 9-11am Calgary Cambridge Consultation Model & History taking (CC 1 – pneumonia)
3 19/02/16 9-10am 12-1pm
Consolidate generic history taking Respiratory History Taking (CC 3 – asthma)
4 25/02/16 9-11am Cardiovascular History Taking (CC 5 – COPD)
5 03/03/16 9-11am Consolidate Respiratory & Cardiac History Taking (CC 7 - AMI)
6 10/03/16 9-11am Abdominal Hx and review FH & SH (CC 9 – Heart Failure)
7 17/03/16 9-11am Review Pain assessment (CC 11 – Gastric Ulcer)
EASTER BREAK
8 07/04/16 9-11am Communication without speaking, learning to listen gathering information techniques. Endocrine History Taking
9 14/04/16 9-11am Giving information & Informing patients Therapeutic Communication during physical examination
10 21/04/16 9-11am Explanation & Planning – clinical decision making Red flag concept
11 28/04/16 9-11am The art of Negotiating a plan MSK History Taking.
12 05/05/16 9-11am Breaking bad news & dealing with bereavement
13 12/05/16 9-11am Closing the consultation Safety netting
14 19/05/16 Exam week
9-11am OSCE practice (communication part only) Self-directed study & catch-up sessions
15 26/05/16 9-11am Neurological History Taking Communicating with colleagues - SBAR
16 02/06/16 9-11am Preparation for clinical practice & SBAR continued
15
Therapeutics & Prescribing
Delivered by both an experienced pharmacist and a non-medical prescriber, medical therapeutics
and prescribing makes use of a two themed approach.
During the first half of the block, there is a strong presence of medical therapeutics, drugs and their
mechanisms of action. The BNF is used as a key source of information and as a clinical tool for
treatment decision making; students are acquainted with its effective use, both as a book and as an
electronic resource.
Post-Easte, the prescribing element of the module is introduced to complement the ongoing
therapeutics. Topics such as prescription writing and mechanisms of prescribing, supplying and
administering are covered.
Assessment will be in the form of MCQs.
Week Date Time Topic
1 05.02 10 - 12 ‘One dose does not fit all’, Using the BNF, information sources. Antibiotics
2 12.02 10 - 12 Resp: drugs for the lungs / asthma drugs and peripheral nervous system
3 19.02 10 - 12 COPD meds Analgesia 1: opiates
4 26.02 10 - 12 CVS 1: categories of meds (ACS, MI) Anti-arrhythmics
5 04.03 10 - 12 CVS: Hypertension and heart failure meds
6 11.03 10 - 12 GI: motility, diarrhoea, anti-emetics, antacids
7 18.03 10 - 12 Urodynamic meds e.g.diuretics, incontinence meds
EASTER BREAK
8 08.04 9 -12 Diabetes Mechanisms of prescribing, supplying and administering medicines
9 15.04 9 -12 Renal, IV fluids and T&P Pharmacovigilance, safe prescribing & prescribing errors
10 22.04 9 -12 Thyroid & Adrenaline & Steroids Prescription writing (FP10, drug chart acute care)
11 29.04 9 -12 Analgesia 2: anti-inflammatory; NSAID, local anaesthetic Recording medications appropriately
12 06.05 9 -12 Blood: clotting & anti-platelets, warfarin, cholesterol Prescribing for specific patient groups
13 13.05 9 -12 Catch up Patient adherence, compliance and concordance. Communication
14 20.05 9 -12 Exam week
15 27.05 9 -12 Epilepsy & neuro-degenerative meds Ethical and legal framework that applies to safe & effective use of medicines and prescribing decisions (CDs, mixing, off-label, unlicensed). ADRs and Yellow Card system
16 02.06 9 -12 Prescription writing & review
16
System Examination These are taught in an interactive, hands-on approach – augmenting lectures, videos and workbooks
and direct & repeated practice. Competence is assessed using OSCEs and set at the level of a medical
student commencing their first clinical placement.
Single system examinations: Respiratory system
Cardio-vascular system
Gastro-intestinal (excluding PR)
Renal system
Reticulo-endothelial system
Peripheral nervous system
Central nervous system
Thoraco-lumbar spine
Cervical spine
Shoulder joint
Knee joint
Combined system examinations: Chest examination
Torso examination
Torso & nervous system examination
17
Investigation interpretation In all cases there is an integration of these investigations with the applied basic sciences covered so
during the 16 weeks. Competence is assessed using OSCEs, clinical scenarios and MCQs.
Imaging
Types
Plain chest radiology
Plain abdominal radiology
Plain spinal (cervical; thoracic & lumbar) radiology
Plain musculo-skeletal (focus on long bones and main joints) radiology
CT abdomen
CT head
MR head
Topics
Transferring gross 3-D anatomical knowledge into a 2-D black & white image
Learning a systematic approach for radiological interpretations
Determine the technical quality of the film
Identifying iatrogenic interventions and their effect
ECG
Types
Rhythm strip
12 lead
Topics
Standardization of ECG recordings
Identification of normal QRS T complexes
Identification of normal PR; ST and QT intervals
A systematic approach to rhythm strip interpretation
A systematic approach to 12 lead ECG interpretation
Full Blood Count (FBC) & coagulation results Systematic approach to FBC interpretation
Identification of common types of anaemia
Identification of common types of coagulopathy
Urea and electrolyte and glucose results Systematic approach to U&E interpretation
Identification of common types of hypo and hypernatraemia
Identification of common types of hypo and hyperkalaemia
Identification of hypoglycaemia and types hyperglycaemia
18
Arterial Blood Gas (ABG) results Systematic approach to ABG interpretation
Identification of compensated and uncompensated respiratory acidosis
Identification of compensated and uncompensated metabolic acidosis
Identification of mixed respiratory and metabolic acidosis
Interpretation of the PaO2 in light of the inspired oxygen concentration
Liver function tests Systematic approach to LFT interpretation
Identification of the three types of jaundice
Identification of the common types of acute hepatitis
Identification of the common types of chronic hepatitis
19
Procedural skills In all cases there is an integration of these procedural skills with the applied basic sciences covered
during the 16 weeks. Competence for those listed as, “Regular use” is assessed using OSCEs and set
at the level of a medical student commencing their first clinical placement.
Regular use:
ANTT
Injections:
Subcutaneous
Intramuscular
Vital sign recording:
Respiratory rate
Heart rate
Blood pressure measure
Tympanic temperature
Pulse oximetry
AVPU
Glasgow coma score
NEWS
Ophthalmoscopy
Auroscopy
Lifting & handling
Intermediate Life support skills Basic life support
Airway management
Defibrillation
Observed & practiced on model Phlebotomy
Cannulation
Catheterization
MDI use
ABG
ECG recording
PR examination
20
Weekly Clinical Conditions
Rationale for a case based course Produce horizontal integration to the first block of the PA programme by linking the key
learning objectives in the previous week’s theme into a single clinical context.
Produce vertical integration to the first block of the PA programme by having cases which
increase in complexity so that they require the use of competences acquired previously in the
course.
Focus on the Emergency & top 20 cases as listed in the National Practitioner Programme.
Encourage team working.
Demonstrate real life aspects in arriving at a diagnosis & management plan:
Time delays in waiting for results
Need for further consultation
Literature searching2
Provide a focus for the end of week round up.
Case based focus The PA faculty have listed a series of competences which the student needs to achieve during the
two year course. A number of these will be introduced during this 16 week block. Consequently
there are many areas of commonality between PA and MBBS curricula. However a straight
duplication of a typical MBBS programme is not appropriate. It would take too long and would lead
to a loss of focus on what the PA students require at this stage in their training.
The approach used at UCLAN will be to base this part of the programme on 15 clinical presentations.
Their selection is based on:
The National Practitioner Programme – mainly 1A cases (i.e. conditions they need to be able to
diagnose and manage without medical assistance)
Relevance to this part of the training scheme
Common adult presentations in Emergency Medicine; Acute Medicine and Primary care
In structuring it this way the aim is to enhance relevance and focus to all teaching episodes.
Selection of cases Appropriate to the week’s theme.
Incorporate as many of the previous week’s key learning objectives as possible.
Build up in complexity as the week progress.
The final case will use the information/ skills of the whole 16 week module placement
Cases:
Community acquired pneumonia
Case 01: Primary care presentation
Case 02: Emergency Department presentation
2 There is potential for increasing the use literature searching later in the programme. For this initial block
focus would be on material they have covered or have already been directed to.
21
Asthma
Case 03: Primary care presentation
Case 04: Emergency Department presentation
COPD
Case 05: Primary care presentation
Case 06: Emergency Department presentation
Acute coronary syndrome
Case 7: Heart Care unit (STEMI)
Case 08: Emergency Department presentation (NSTEMI)
Left ventricular failure
Case 09: Primary care presentation
Case 10: Emergency Department presentation
Bleeding peptic ulcer
Case 11: Primary care presentation
Variceal bleed
Case 12: Emergency Department presentation
Diverticular disease
Case 13: Primary care presentation
Ulcerative colitis
Case 14: Emergency Department presentation
Diabetes
Case 15: Primary care presentation
Case 16: Emergency Department presentation
Jaundice
Case 17: Primary care presentation
Case 18: Emergency Department presentation
Palpitations
Case 19: Primary care presentation (Thyrotoxicosis)
Case 20: Emergency Department presentation (Atrial fibrillation)
Fractured neck of femur
Case 21: Emergency Department presentation
Hot joint (Infective)
Case 22: Emergency Department presentation
DVT (Leading to PE)
Case 23: Emergency Department presentation
22
Hot joint (Arthritis)
Case 24: Primary care presentation
Cellulitis
Case 25: Primary care presentation
Case 26: Emergency Department presentation
Ischaemic Stroke
Case 27: Emergency Department presentation
Case 28: Emergency Department presentation
Epilepsy
Case 29: Primary care presentation
Syncope
Case 30: Emergency Department presentation